UM Services Coordinator

Job Title

This position is responsible for coordinating services, managing utilization, and authorizing initial and ongoing services for children and families involved in the child welfare system. The role ensures the effective, efficient, and fiscally responsible use of agency resources through oversight of service planning, authorization, delivery, reimbursement, and provider compliance.

Key responsibilities include fiscal management, providing support and consultation to Clinical Coordinators, and maximizing third-party reimbursement and alternative funding sources whenever available. The position participates in case review meetings, reviews and approves service requests, obtains and maintains all required documentation to support service authorizations and payments, prepares and processes requests for checks, reviews and authorizes invoices. The incumbent validates provider billing by reviewing submitted invoices and supporting documentation to ensure services billed, accurately documented, medically necessary, and compliant with agency standards, funding requirements, and contractual obligations.

This includes reviewing provider progress notes to verify that they support billed services and meet established documentation standards.

This position is also responsible for tracking and monitoring Community Mental Health (CMH) funding, maintaining accurate funding and utilization data, and ensuring expenditures remain within authorized funding limits. The incumbent proactively monitors required documentation, authorizations, and funding-related deadlines; notifies team members of missing documentation, pending authorizations, and upcoming expirations; and collaborates with internal staff and external providers to ensure continuity of services and compliance with funding and regulatory requirements.

The position coordinates the onboarding of new service providers by obtaining required credentialing and contracting documentation, providing training on agency policies, utilization management procedures, documentation standards, billing requirements, and system workflows. The incumbent serves as a subject matter expert by providing ongoing technical assistance and system support to providers and agency staff, troubleshooting system issues, answering questions related to service authorizations, billing processes, and documentation requirements, and promoting consistent application of agency procedures and best practices.

Also includes data management and reporting, to maintaining accurate utilization and authorization records within agency systems.

Additionally, this position promotes individualized, family-centered, culturally responsive, and trauma-informed treatment planning. The incumbent ensures that services and interventions are flexible, evidence-informed, and tailored to meet the unique strengths, needs, and cultural backgrounds of the children and families served. This role serves as a resource to staff and providers on utilization management, fiscal accountability, procurement requirements, funding guidelines, billing compliance, documentation standards, and electronic systems to ensure high-quality, compliant, and fiscally responsible service delivery.

Essential Functions:

Participation in Case Review Teams – Essential Function:
This position participates in Review Teams, ensures the appropriateness of services requested and reviews service delivery for families served in the child welfare system.

Service Authorizations – Essential Function:
This position is responsible for service authorizations for bypass referrals, initial and ongoing services. This position utilizes 3rd party payment and other alternative community resources whenever possible ensuring the most efficient and effective use of agency resources.

Utilization Management – Essential Function:
Ensure that services authorized are fiscally appropriate and that type, frequency, and duration of service delivery matches child and family need with regulatory review and the maximization of resources.

Service Prioritization and Partnership with Case Managers – Essential Function:
This position will partner with Case Managers in the…